Tag Archives: European Journal of Pain

Vibration can help reduce some types of pain, including pain from FM, by more than 40 per cent, according to a new study published online in the European Journal of Pain.

When high-frequency vibrations from an instrument were applied to painful areas, pain signals may have been prevented from travelling to the central nervous system, explains Roland Staud, MD, professor of rheumatology and clinical immunology in the University of Florida College of Medicine in Gainesville.

If you think of a pain impulse having to travel through a gate to cause discomfort, the vibrations are closing that gate. “When the gate is open, you feel the pain from the stimulus. It goes to the spinal cord. When you apply vibration you close the gate partially,” says Dr Staud. You can still feel some pain, but less than you would have felt without the vibrations, he adds.

Subjects were split into 3 groups: 29 had FM, 19 had chronic neck and back pain and 28 didn’t have any pain at all. Dr Staud and his research team applied about five seconds of heat to introduce pain to each participant’s arms and followed that with five seconds of vibrations from an electric instrument that emits high-frequency vibrations that are absorbed by skin and deep tissue.

A biothesiometer

Dr Staud used a biothesiometer, an electric vibrator (not THAT kind of vibrator – get your mind out of the gutter!) with a plastic foot plate that can be brought into contact with the patient’s skin.

Compact TENS

Similarly, you could buy/borrow a Transcutaneous Electrical Nerve Stimulator (TENS), which is a medical device, designed specifically for the purpose of assisting in the treatment and management of chronic and acute pain; and it does exactly what Dr Staud is suggesting. I am currently borrowing a compact TENS machine. The pulse rate is adjustable from 1-200 Hz.

Following the use of heat and vibration, patients were asked to rate the intensity of their pain on a 0-to-10 scale and found that the experimental pain, as opposed to their chronic pain, was reduced by more than 40 per cent with the use of vibration. What was of particular interest was that the patients in the study with FM appeared to have the same mechanisms in their body to block or inhibit pain through the use of vibration as those in the pain-free group.

“Fibromyalgia patients are often said to have insufficient pain mechanisms, which means they can’t regulate their pain as well as regular individuals. This study showed that in comparison to normal controls, they could control their pain as well,” Dr Staud explains.

What they don’t know is how long the pain relieving effects will last.

I used the TENS on my arms two days ago and the pain has not returned (yet! Knock on wood!) If I choose to buy it, it will cost me $175.00 from www.tensaustralia.com.au

Dr Howard, a rheumatologist and director of Arthritis Health in Scottsdale, Ariz., says this study is still very interesting. “Vibration is another way of minimizing pain, and it sounded like it would be more helpful for regional or local pain rather than widespread pain,” he says.

Dr Staud says this theory is still very much in the testing stages and the vibrating instrument used in this study isn’t available to the public. “Although we didn’t test it, I think that the size of the foot plate of the biothesiometer is relevant. I wouldn’t suggest that everybody should go out and by any vibrator to use for pain relief. But pending a commercial product this is entirely feasible,” he explains.

Until then, Dr Staud’s message for patients is that vibration involves touch, and that can provide pain relief.

Dr Howard agrees that this study reinforces the importance of touch therapy, like massage, and even movement therapy, like gentle exercise, for people with chronic pain.

“When you have pain, you want to stop what you’re doing and protect the area. But for some types of pain that’s not the right thing to do,” Dr Howard says.

You do, however, need to know what types of pain touch is good for and for which ones it isn’t. Dr Howard says his general rule is to baby your joints and bully your muscles.

“Fibromyalgia patients often shrink away from touch therapy and movement. The foundation of treatment is to use movement and touch and stimulus to help with their pain, but their natural reaction is to withdraw and avoid tactile activity. Don’t be afraid. Don’t avoid it,” Dr Howard says.

Good forms of touch therapy include massage and the use of temperature – both hot and cold. Good forms of movement therapy include tai chi, yoga and swimming/warm water exercising.

Hypnosis may sound like voodoo, but it’s not. Hypnotherapy is a legitimate treatment method one that many patients with FM swear by. Hypnosis is now emerging as one of the best alternative treatments available for FM pain. The use of hypnosis has been proven to reduce pain symptoms and it has become a doctor-recommended treatment. If you are suffering from pain, you may want to consider hypnosis as a treatment option. While hypnosis may not be a cure, it could provide a simple yet effective means to reduce pain for many people.

What is Hypnosis? Hypnosis is a non-invasive technique that encourages you to achieve heightened levels of focus and sensation. People who practice hypnosis believe that there are two main components to the mind: the conscious mind and the unconscious mind. Through relaxation and suggestion, you are able to access your subconscious mind and stop behaviours or thoughts that may be contributing to pain or other unpleasant symptoms.

Contrary to popular belief, though, people who are in a state of hypnosis are not unaware of their actions and will not do anything that they have a serious moral or ethical objection to. In fact, you do have control over your actions as well as what you say while you are hypnotized. Moreover, you have the ability to remember what transpired while you were hypnotized. However, in some cases, your subconscious mind may choose to ‘forget’ just what happened.

In 1991, an article appeared in The Journal of Rheumatology about a study consisting of 40 patients who had not seen results from other forms of treatment for their FM. They were randomly selected to receive either hypnotherapy or physical therapy. They received either form of therapy for 12 weeks. All participants were assessed by the researchers at a 12 and 24 week follow-up.

Before the start of the study, all patients reported feeling discomfort both mentally and physically.

During both the 12-week and 24-week assessments, the participants in the hypnotherapy group reported a reduction in pain and fatigue and they also reported better sleep. Their assessments at the 12 and 24-week follow-up were compared to the baseline reporting of the HSCL.

At the follow-up, those who received hypnotherapy reported a significant decrease in feelings of discomfort. However, those who received physical therapy did not report any significant decrease.

The researchers in this study concluded that hypnotherapy is a useful tool to help relieve pain and other symptoms associated with FM.

The July 2008 issue of the European Journal of Pain details a study which examined hypnosis and pain management in patients suffering from FM. Using fMRI (functional magnetic resonance imaging), the researchers compared two groups of sufferers. One group was given suggestions for pain management without hypnotic induction, while the other group received the same suggestions after hypnotic induction.

Researchers then took brain scans of each group, and asked each group about their levels of pain. Both groups reported less pain after suggestion, but those who had been hypnotized reported more feelings of personal control of their pain – they felt more empowered as far as being able to manage their pain levels. The brain scans in the hypnotized group showed greater activity compared to the non-hypnotized group.

Based on this, the researchers concluded that hypnosis increases the effectiveness of FM pain management.

Types of Hypnosis
There are two main types of hypnosis techniques:

Hypnosis Performed by a Clinical Hypnotist: This type of hypnosis is performed in-office by a licensed professional. The hypnotist will explain what hypnosis is and how it works to reduce pain. He or she will then lead you into hypnosis through a series of relaxation exercises. Once you are in a hypnotic state, the hypnotist will make suggestions as to how you can change your thoughts or behaviour in order to minimize your symptoms.

Self-Hypnosis: Self-hypnosis is a type of hypnosis that you can do yourself in the privacy of your own home. You can learn self-hypnosis either from a clinical hypnotist or from one of a number of books available on the subject. Self-hypnosis programs and hypnotherapy courses are also widely available. Self-hypnosis techniques can be indispensable for FM sufferers. Self-hypnosis is usually used as a form of relaxation or meditation.

Stages of Hypnosis
There are three main stages of hypnosis. Your hypnotist will lead you into a certain stage of hypnosis, depending upon the illness or symptom you wish to treat.

First Stage: The first stage of hypnosis is often referred to as a superficial trance. This is the lightest stage of hypnosis, during which you are aware of all of your surroundings. This type of trance is commonly used to help correct addictive behaviours such as smoking. During a superficial trance, you will accept suggestions but may not act upon them afterwards.

Second Stage: The second stage, the alpha state, is a deeper level of hypnosis. You may notice that your breathing begins to slow down, as will your heart rate and blood pressure. It is this stage of hypnosis that is used to control pain.

Third Stage: The third stage of hypnosis is the deepest. Psychiatrists use this stage to access forgotten emotions, memories, and events. It is often used to help those who have undergone severe psychological trauma.

How Does Hypnosis Work? Researchers are not completely sure how hypnosis therapy works or why it works so well in fibromyalgia patients. A recent study performed at the University of Iowa looked to explain what actually happens to the brain during hypnosis. Brain scans were taken of chronic pain sufferers in hypnotic trances and analysed for activity changes. Researchers found that people under hypnosis had reduced activity in pain network areas of the brain. In particular, the area of the brain responsible for ‘feeling’ pain had significantly reduced activity levels. This suggests that hypnosis treatment works because it actually has a physical effect on the brain.

Effects of Hypnosis on Fibromyalgia Sufferers
Many FM sufferers attribute reduction in their symptoms to the power of hypnosis. As stress may have been a major contributor to the onset of FM, it is vital to introduce a means for the FM patient to manage and reduce their stress levels. Hypnosis has proven to be highly effective in this area. Self-hypnosis is a practice that when used regularly reduces stress and encourages relaxation and well-being.

FM sufferers often use hypnosis as a way to limit their pain symptoms and increase their energy and comfort level. A study conducted by the NIH showed that fibromyalgia sufferers undergoing hypnosis reported 80% fewer pain symptoms than those who received no hypnosis treatment. Other benefits of hypnosis include:

decreased muscle pain

decreased morning fatigue

fewer sleep difficulties

increased relaxation

So, if other methods of treatment have failed, one might consider this alternative therapy. The idea is that with hypnosis, FM sufferers’ quality of life can be bettered. Many people, including me, have a pre-conceived notion about hypnosis – may it be the idea of ‘letting someone into your head’ or just that it won’t work. The fact is, no one is actually taking control of your conscious state, the therapist is actually empowering you to take control!
It can’t hurt and you may gain some freedom from your pain! To me, that’s a plus!

Things to Remember Before engaging in any type of hypnosis there are a few things to keep in mind:

Be sure to find a licensed clinical hypnotist. There are many unlicensed hypnotists operating throughout the United States. Clinical hypnotists have specific training in both medicine and psychology.

Hypnosis doesn’t work for everyone. Up to 10% of the population can’t be hypnotized.

If you are suffering from a psychiatric condition or any type of psychosis, do not undergo hypnotism without first speaking with your health care professional.